Provider Demographics
NPI:1083772404
Name:TESTA, ANTHONY F (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:F
Last Name:TESTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 ATWOOD AVE
Mailing Address - Street 2:SUITE340
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3228
Mailing Address - Country:US
Mailing Address - Phone:401-273-0220
Mailing Address - Fax:401-274-6059
Practice Address - Street 1:1524 ATWOOD AVE
Practice Address - Street 2:SUITE340
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-273-0220
Practice Address - Fax:401-274-6059
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI4822207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI8432930OtherCIGNA
RIUNITED HEALTHCAREOther3000119
RI002249OtherBLUE CHIP
RI9001589Medicaid
RI1589-9OtherBLUE CROSS & BLUE SHIELD
RI0961584OtherAETNA
RI9001589Medicaid
RI002249OtherBLUE CHIP